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02/22/2013 FRI 14:40 FAX 402 471 4429 UCC SECRETARY OF STATE <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />Area: <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829 -7650 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following -named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer JUAN AJQUI <br />Residence <br />IMPORTANT. RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is ref iled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br />1040 <br />1040 <br />Place of Filing <br />the <br />Signature <br />3595 <br />Tax Period <br />Ending <br />(b) <br />12/31/2004 <br />12/31/2006 <br />12/31/2007 <br />1.2/31/2008 <br />06th day of February 2013 <br />for PAMELA J ROGERS <br />916 W 16TH ST <br />GRAND ISLAND, NE 68801 -3520 <br />Identifying Number <br />(c) <br />XXX -XX -4364* <br />XXX -XX -4364* <br />XXX -XX -4364* <br />XXX -XX -4364* <br />Notice of Federal Tax Lien <br />Serial Number <br />Date of <br />Assessment <br />(d) <br />09/2 8/2009 <br />08/31/2009 <br />08/31/2009 <br />08/31/2009 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />920841313 <br />Title <br />ACS W &T <br />(800) 829 -7650 <br />Hall <br />Department of the Treasury - Internal Revenue Service <br />201301438 <br />Last Day for <br />Refiling <br />(e) <br />10/28/2019 <br />09/30/2019 <br />09/30/2019 <br />09/30/2019 <br />For Optional Use by Recording Office <br />NE Sec of Stele John A Gal <br />111 1111 <br />9913709188 -6 <br />AJOUI JUAN <br />Filed: 02/22/2013 01:23 PM <br />Total $ <br />Unpaid Balance <br />of Assessment <br />(f) <br />This notice was prepared and signed at CHICAGO, IL <br />12772.24 <br />U1002/004 <br />2233.87 <br />3661.24 <br />3740.05 <br />3137.08 <br />, on this, <br />14 -00 -0000 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rut. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004) <br />Part I - Kept By Recording Office CAT. NO 60025X 1L" <br />